Arimidex, Aromasin, Femara — Aromatase Inhibitors and Breast Cancer

I’ve been asked by several people to write about this topic. Women who had Estrogen Positive Breast Cancer and are post-menopausal, are given Aromatase Inhibitors after active cancer treatment for 5 years, and new studies are being done to see if 10 years is beneficial. Breastcancer.org describes it as follows:

Aromatase inhibitors stop the production of estrogen in postmenopausal women. Aromatase inhibitors work by blocking the enzyme aromatase, which turns the hormone androgen into small amounts of estrogen in the body. This means that less estrogen is available to stimulate the growth of hormone-receptor-positive breast cancer cells.

Aromatase inhibitors can’t stop the ovaries from making estrogen, so aromatase inhibitors only work in postmenopausal women.

There are three aromatase inhibitors:

Arimidex (chemical name: anastrozole)

Aromasin (chemical name: exemestane)

Femara (chemical name: letrozole)

Each is a pill, usually taken once a day. Arimidex and Femara are available as generic medicines.

I take Arimidex (generic Anastrozole). I was pre-menopausal before Chemotherapy even though I am in my mid-50s. My Oncologist was debating whether to prescribe Tamoxifen which is given to pre-menopausal women or an Aromatase Inhibitor. He asked me to research it and give him my input, which I appreciated. I strongly felt the Aromatase Inhibitor was a better fit for me. He agreed, but said it would be necessary to closely monitor my hormones to make sure I stayed post-menopausal. I had blood tests every week for quite some time, but fortunately, I stayed post-menopausal.

I’ve been on Arimidex for 5 months. I tried not to read too much about side effects because I didn’t want to influence my mind. However, I do have side effects. The absolute worst is severe joint pain. In the mornings it is debilitating. It is extremely difficult for me to even get down my staircase. It is way beyond “every bone in your body hurts” feeling. And when I stand up from a chair, for the first few minutes I can hardly move. I’ve learned to stay standing for 30 seconds before I walk. That helps. As the day progresses, it gets much better. I suffer through it because Breastcancer.org also says joint pain is a good sign:

Joint pain from taking an aromatase inhibitor can be troubling. But a 2008 British study suggests that women who experienced joint pain while taking hormonal therapy medicine were less likely to have the breast cancer come back (recur). Knowing that this side effect might indicate a reduced risk of the cancer coming back may help some people stick with treatment despite the side effects.

Other side effects I experienced was dizziness after taking the pill. My Physician’s Assistant told me to take it before bed so if I get dizzy, I won’t know it. That worked! Hot flahses are also a biggie. In the first few months of taking Arimidex, I was awakened at least 5 to 6 times per night with hot flashes. It has gotten better. Weight gain is the other significant side effect especially in belly fat. I’ve always struggled with my weight. The weight I lost during Chemo came flying back the minute I started taking Arimidex. I try to exercise on my Gazelle as often as possible to help both the joints and the weight gain.

Bone loss is another huge factor. Patients on Aromatase Inhibitors are monitored with Dexa Scans to determine if there is bone loss.

Cost is another matter. Aromatase Inhibitors are very expensive even in generic. Make sure you shop around! For Anastrozole, the generic for Arimidex, was $300.00 at Walmart for 3 months, $180.00 at a local pharmacy, and $48.00 at Costco for 3 month supply! You do not have to be a member of Costco to use their pharmacy.

When I asked my Physician’s Assistant, “How do I know this is working?” she simply stated that the side effects tell the story. So, I know the drug is working for me. And I console myself with that fact as I struggle along.

If you are taking an Aromatase Inhibitor, please post and let us know your side effects and how you are coping! Thanks so much….PS: I have had a major breakthrough in joint pain by taking an organic apple cider vinegar . It is miraculous in the 5 weeks I’ve been taking it. I use Bragg’s Organic (bought at health food store) and mix with water or juice. I use 2 teaspoons three times per day – mid – morning, mid – afternoon, and mid – evening. If I forget it, I notice the difference. I asked my Nurse Practitioner if it was okay to take it and she said, “Absolutely!”

Published by Denise McCroskey

I started this Blog on the day of my diagnosis with Stage 3 Triple Positive Cancer. Little did I know within the next 3 years my mom would be diagnosed with Stage 1 Breast Cancer, followed by my only sibling, my sister and best friend with Stage 3 Breast Cancer. I've documented every step along the Breast Cancer path - Mastectomies, Chemotherapy, Radiation, Herceptin, Hormone Therapy, Aromatase Inhibitors, my sister's reconstructive sugery and transition to Cancer Survivors. I want to help others going through this overwhelming and frightening journey. I want to help you and give you hope.
View all posts by Denise McCroskey

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36 comments

I too take Arimidex and not only suffer joint pain and chronic low back, but wake up every morning with “trigger fingers.” In looking at other blogs this seems common. I deal with the pain because it beats the alternative!

1st time ever commenting on line but breast cancer is quite the journey I have been taking anastrozole for a yr had a mastectomy now have to do chemo and then radiation the hope was that I wouldn’t have to do either The anastrozole has given me bone pain, muscle aches ,joint pain my balance is way off I walk w a cane my thumb joints are popping ? my hands are on fire 24/7 sometimes worse than other times {nerve damage?} among other things I was off the med during and after surgery about a month I almost started to feel normal I too have low back pain difficulty moving or walking I also learned to wait a couple minutes after getting up also as the day goes on it gets better especially if I am moving I am a little unnerved about the port placement & chemo I cant imagine all those drugs in my body All of this before knowing about side affects my dr said most women don’t even know they are taking it but then I looked it up I was not crazy or a hypochondriac after several conversations over time He finally conceded it might be I KNOW IT IS

Hi Candace, so sorry you find yourself now facing chemo and rads after you have been on Anastrozole for a year.
That is not usually the order it occurs in – did you have a different situation.
Oh my, your doctor is not tuned in if he thinks most women don’t even know they are taking it! I have heard
of very few women that don’t!
And no you are DEFINITELY not crazy or a hypochondriac! My sister and I find that the weather really affects us.
My Blog has ALOT of information on it regarding chemo and rads. You can get through it. Also, regarding Anastrozole
some women do better on other AI drugs My suggestion is to talk to your doctor about this.
Sending all my best wishes! Denise

I will post about the vinegar next week to give all the details. But I bought Bragg’s Apple Cider Vinegar at a local health food store. I also noticed they had it at my grocery store in the organic section. It was $3.99 so not a bad price. I take 2 tsp 3 times per day – I put it in some pomegranate juice as it cuts the taste and drink through a straw as it can hurt your teeth enamel. my best, Denise

Oh gosh, thanks for this info, Cindy. I will check it out with Arimidex!! I knew
about grapefruit, but that is all. THANK YOU!! I will post more when I do a little
more research as far as the other drugs are concerned!

I’m not hormone positive but, my oncologist suggested taking Clartin for bone pain. I’m in the I SPY 2 trial and I’m taking a yet to be named drug called MK2206 along with Herceptin and Taxol. I also have to take Neupogen shots to boost my white blood cells. The Clartin has really helped with my bone pain, be sure and take the regular Clartin not the Clartin D. Hopes this helps.

Hi Katie, I took Claritin during Taxol and it helped tremendously.
Never thought about Claritin with Aromatase Inhibitors. I will see if
there is any info out there on it. Thanks for letting us know about the I-SPY 2 trial
and the unnamed drug called MK2206. I will check it out. Good luck to you!!
If I can be of any help, just write me at b4Denise@hotmail.com
Denise

Denise, it’s you who you has helped me! Thank you for all the information you have compiled and disseminated to all of us. I really feel lucky to be in this I SPY2 trial. After just 3 chemo treatments my tumor shrunk by 33%! Yippee!!

Katie, that is truly amazing! So happy to hear this. I read about the
ISPY2 trial and it sounds most interesting. Please check in on occasion
if you feel like it. I want to tell other women about this! Thank you
so much for telling me and others about it! Denise

Hi Denise, I just finished my 6th round of Taxol, Herceptin, and MK2206 and I feel very good. The doctors have all said they are seeing miracles coming out of this I SPY 2 Trial. I would highly encourage all women and men who qualify, to try and get to a hospital that is participating in this trial. I do know it is going on all over the country at top cancer centers. I have to have a lot more tests and scans which the trial pays for and I feel like I am being well monitored. They are not using a placebo in any arm of the trial and you can stop at any time if you are unhappy. This has certainly been a win win for me. Thank God!

Katie, I am going to send you an email to talk with you a little
more on this…please watch for it in case it goes to your junk folder!
Thanks for sharing your good news. I want to write more about this
so others know about it! Denise

I need you knowledgeable input–Please! I started my 33 visits of radiation on March 18th. That night I had breast pain in the operated breast and it was very pink. The next day the nurse said I had an infection and put my on Levaquin for a week. Strange, I didn’t know I had an infection in my breast until after radiation?? It continued to be pink the whole week but no more pain at night. Went back this Monday start of 2nd week and now the doctor says if it’s not an infection I have lymphodemea in my breast???? Never heard of it–I however have lymphodemea in my arm and hand for awhile now. What are your thoughts and also–I am tired, depressed what ever–can I take vitamins?

Hi Denise, Just read your blog. I’m so sorry that you have so much pain. That sure makes life difficult. Who knew how much cancer patients endure? It is so good you are willing to share your story. I can imagine how sharing your vast knowledge helps others cope. ________________________________

I have been on Anastrozole for just over two years. I too have experienced joint pain. It has actually worsend my carpal tunnel sydrome bilaterally and I get pain at the base of the thumbs. Ibuprophen helps. I will try the organic apple cider vinegar. Has anyone had any luck with cherry juice? I have heard so much good about that. It is hard to deal with discomfort, but I try to work through it daily. It has not been that debilitating for me. I was diagnosed in late Sept. 2010 with Stage 1 invasive ductal cancer. (estrogen induced.) Only required a lumpectomy and radiation. I will stay on the Anastrozole as long as I can. Symptoms vary for each individual. People need to keep that in mind. Prayers for everyone out there undergoing treatment.

I, too, have severe pain at the base of my thumbs, I now take letrozole, originally took arimidex after left-breast mastectomy. I actually cried when I read your post, as it made me feel less alone. It’s encouraging to hear that joint pain is one measure of the drug’s effectiveness. Hang in there.

I am pleased to see the responses from both of you. I have been on Anastrozole for 18 months and of all the side effects (of which there are many) the worst is the trigger finger/thumb in both hands and weight gain. I’ve told many it’s like menopause (again) on steroids!! I’m going to try both the Claritin AND the apple cider vinegar, why not. I’m also taking tumeric. We shall see. Good to know that we are not alone. But we ARE in pain!!

Thanks for posting! Yes we are in pain! I am now in Year 4 of Anastrozole and I am better than I was.
But I notice a big change from different manufacturers of the drug! My sister is also on Anastrozole and
notices this as well!! Pay attention to this – perhaps change pharmacies and try another manufacturer!
ALL THE BEST!

I started on Tamoxifen last night and will be watching carefully for side effects…..I am more than happy to take this and will be looking out for any side effects! I feel so blessed to be able to take this drug as I know it will be helping me….to complement chemo and radiation.. When blood tests confirm that I am post menopausal (I’m convinced I am since chemo) then I’ll ask about other inhibitors with fewer known side effects.

Hi Denise, I just started on Arimidex this week. I have read on the Arimidex forum on Breastcancer.org, that many with the joint pains take gin-soaked raisins. You soak golden raisins in gin for 2 weeks in the fridge. Then you eat 8-9 raisins each day. The combination of the two produces a natural cortisone effect for achy joints. My SIL is a geriatrician and she says she has many patients taking this who normally cannot tolerate other pain meds.

Hi Denise, I have been on Arimidex for one year and had to wonder if my quality of life outweighed the risk of reoccurence. So, a few days ago I met with my oncologist and she switched me to Tamoxifen. She said that I would feel much better in a month. I’m giving it a try and hope to find a solution to all this pain! There are some interesting ideas posted here! God bless everyone 🙂

Hi All, I am in the UK and had Tomoxifen for two years and been on Letrozole for three, obviously I get this free because of our a National Health. I have joint pain which seems to be getting worse and have today brought some apple cider tablets but can’t find if these are ok to take. Does anyone know

I am on Arimidex (Anastrozole), also an AI – I took apple cider tablets and/or
drank apple cider. It helped. My Nurse Practitioner said it was okay and would
not hurt me or interact with the drug! Let us know if it helps!

I have IDC grade II, NO MO Stage 1A, under went lumpectomy and now after chemo 4 treatments, radiation 38 treatments. Letrozole 2.5 mg prescribed. Very worried about taking this drug. Have you heard in your blog from woman who did not take or did not stay taking this drug and if they had recurrence? There are no gathered stats on the woman who did not take or did not continue to take this hormone therapy after being treated and I am trying to decide if I am going to take this medicine or take my chances using natural/diet/exercise instead. Any information would be truly helpful to making my decision. Fear is a terrible reason to make a decision.

I have been on Anastrozole for about 2 years and finally landed upon Tumeric to help. I have to say that the support groups have been the best source of remedies. I have not tried actual vinegar (I’ve taken the capsules and not sure they are helping), I will try liquid. I’ve got a million side effects, but the worst was going back into menopause and joint pain – trigger finger and thumbs, both hands. My doctor suggests exercise, ha! I ache too much to do that, but I’m trying. My most hated side effect?…weight gain!! (and my boobs are huge and they are still all mine!) My cancer was 100% estrogen driven, so the oncologist says I’m on Anastrozole for 10 years!
Thank you for this and hang in there ladies!!

Denise:
I just read your blog and am happy to see that someone else blesses the pill before they take it! I have so many pills that I have one of those “old people” containers, and at first I was damning the pill as I assigned it to it’s spot. I decided that blessing it was better. Of the Anastrozole, my oncologist said that if he had a choice of me doing chemo, or taking the drug, he would advise the drug!!
I will join forces with you to advise others to take it too!!

Thanks, Pam! Great to hear! I know many Stage 4 women who have only been on the
AI drugs and it is keeping the cancer contained. Now that is miraculous!
Thanks for joining forces to advise others to take it!! HOORAY!

You know what I forgot to ask, and perhaps someone on here knows…I was not thin when I started the program, but the weight gain…jeez louise. Does anyone have tips and/or answers for this. The size of my breasts have increased 10-fold, I have gained from my armpits to my a**! Ideas? Does anything work? (It feels a lot like menopause weight gain.)

I recently began Aromasin however, I was pre menopausal, it wasn’t until I began chemo that I began not having periods. I completely trust my oncologist. The bone pain has been incredibly painful along with lower back pain. This is my first month and I’m struggling with the pain it’s causing. I want to figure out how to live with what pain I have to live with and try my best not to let it effect me so much emotionally that it make life miserable for my family. I have 2 boys 13 and 11-1/2 and my patience isn’t great. My radiation oncologist has suggested turmeric and I’m trying that now. Thank you for your blog. It helps knowing I’m not alone in this struggle

Hi – oh those AI drugs can be SO PAINFUL at first you wonder how you will ever make it.
Especially when you have active young boys! Tumeric does help for a lot of women.
When my pain was almost unbearable, I started taking 2 Aleves every other day once per day.
It REALLY took off the edge. I didn’t want to overdose on them, so the every other day
seemed to stretch out and numb some of the pain!
Thanks for your kind words and wishing you well.

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Breast Cancer Blogger

I started this Blog on the day of my diagnosis with Stage 3 Triple Positive Cancer. Little did I know within the next 3 years my mom would be diagnosed with Stage 1 Breast Cancer, followed by my only sibling, my sister and best friend with Stage 3 Breast Cancer. I've documented every step along the Breast Cancer path - Mastectomies, Chemotherapy, Radiation, Herceptin, Hormone Therapy, Aromatase Inhibitors, my sister's reconstructive sugery and transition to Cancer Survivors. I want to help others going through this overwhelming and frightening journey. I want to help you and give you hope.